The sixth sense: how much does interictal intracranial EEG add to determining the focality of epileptic networks?

Intracranial EEG is used for two main purposes: to determine (i) if epileptic networks are amenable to focal treatment and (ii) where to intervene. Currently, these questions are answered qualitatively and differently across centres. There is a need to quantify the focality of epileptic networks systematically, which may guide surgical decision-making, enable large-scale data analysis and facilitate multi-centre prospective clinical trials.

Pitfalls in scalp EEG: Current obstacles and future directions.

Although electroencephalography (EEG) serves a critical role in the evaluation and management of seizure disorders, it is commonly misinterpreted, resulting in avoidable medical, social, and financial burdens to patients and health care systems. Overinterpretation of sharply contoured transient waveforms as being representative of interictal epileptiform abnormalities lies at the core of this problem. However, the magnitude of these errors is amplified by the high prevalence of paroxysmal events exhibited in clinical practice that compel investigation with EEG.

Quantifying interictal intracranial EEG to predict focal epilepsy.

Introduction: Intracranial EEG (IEEG) is used for 2 main purposes, to determine: (1) if epileptic networks are amenable to focal treatment and (2) where to intervene. Currently these questions are answered qualitatively and sometimes differently across centers. There is a need for objective, standardized methods to guide surgical decision making and to enable large scale data analysis across centers and prospective clinical trials.

Quantifying trial-by-trial variability during cortico-cortical evoked potential mapping of epileptogenic tissue.

Objective: Measuring cortico-cortical evoked potentials (CCEPs) is a promising tool for mapping epileptic networks, but it is not known how variability in brain state and stimulation technique might impact the use of CCEPs for epilepsy localization. We test the hypotheses that (1) CCEPs demonstrate systematic variability across trials and (2) CCEP amplitudes depend on the timing of stimulation with respect to endogenous, low-frequency oscillations.

Methods: We studied 11 patients who underwent CCEP mapping after stereo-electroencephalography electrode implantation for surgical evaluation of drug-resistant epilepsy.

Extracting seizure frequency from epilepsy clinic notes: a machine reading approach to natural language processing.

Objective: Seizure frequency and seizure freedom are among the most important outcome measures for patients with epilepsy. In this study, we aimed to automatically extract this clinical information from unstructured text in clinical notes. If successful, this could improve clinical decision-making in epilepsy patients and allow for rapid, large-scale retrospective research.

Patterns of seizure spread in temporal lobe epilepsy are associated with distinct white matter tracts.

Objective: It is commonly hypothesized that seizure spread patterns in patients with focal epilepsy are associated with structural brain pathways. However, this relationship is poorly understood and has not been fully demonstrated in patients with temporal lobe epilepsy. Here, we sought to determine whether directionality of seizure spread (DSS) is associated with specific cerebral white matter tracts in patients with temporal lobe epilepsy.

Rate of colonization of health care workers by carbapenem-resistant Enterobacteriaceae in an endemic hospital: A prospective study.

The role of health care workers in transmission of carbapenem-resistant Enterobacteriaceae (CRE) has not been evaluated thoroughly. We sought to determine the rate of fecal carriage of CRE among health care workers in our hospital, which is endemic for CRE (prevalence of 19 out of 800 beds and incidence of 128 out of 49,325 hospital admissions). We found no carriers among the 177 health care workers that participated in the study, suggesting that transmission does not occur through personnel gastrointestinal carriage of the bacteria.